I had a poor rhinoplasty 5 years ago leaving me with collapsed upper lateral cartilages and agressive removal of lower lateral cartilages.When I pinch my nose I cannot feel any cartilage support at all supporting my nostrils and sidewall of nose.My skin is average thickness and very loose since the rhinoplasty.Is it possible that the skin did not reattach to any cartilage and formed scar tissue(because the cartilage was collapsed/removed)causing this to happen?Is it repairable with a revision?
Is It Possible for Skin to Not Reattach to Cartilage After Rhinoplasty?
Doctor Answers (7)
Skin not "reattached" after Rhinoplasty
What you describe is not a problem of the skin "reattaching" to the cartilage after your rhinoplasty but that it sounds like you don't have enough cartilage structure to support the weight or amount of nasal skin you have. Over-reduction of the natural nasal cartilages in rhinoplasty instead of reshaping them can lead to this problem. It is definitely correctable with revision rhinoplasty. Rebuilding some of the lost nasal shape with cartilage grafts from the septum, ear, rib or cadaveric rib cartilage can restore structure to the middle third, upper lateral cartilages and nasal tip and nostril support to achieve a functional and attractive nose.
Seeking revision Rhinoplasty
I have performed Rhinoplasty and revision Rhinoplasty for over 20 years and yes, sometimes the mucosal lining of the tip cartilages does not re-attache when a very specific type of tip thinning technique (delivery technique) is used, IMHO. Nothing takes the place on an in person examination or photos for a more thorough evaluation.
it's not that your skin doesn't attach, it's likely that you don't have enough cartilage structure to support your skin, nostrils and tip. In both primary and revison rhinoplasty the goal is creation of a stable supporting underlying structure which the skin can then conform to. This can be done in revision rhinoplasty for you.
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Skin will reattach after rhinoplasty
Your skin will reattach to the remaining cartilage after rhinoplasty. We dislike any technique which is described as aggressive, especially in rhinoplasty. Nasal shaping is often a 'subtractive' procedure, though leaving adequate support remaining for the tip and airway are important. If your tip lacks support and shape and the bridge is pinched revision can be effective with appropriate cartilage grafting.
Best of luck,
Collapsed Upper Lateral Cartilages and Overresected Lower lateral Cartilages
Yes it is possible to fix this. If you follow the link below you will go to a page on my website that addresses your questions. The upper lateral cartilages may need to be reinforced with cartilage grafts and the lower laterals may need the same. The cartilage graft can be taken from the septum or ear. This surgery should be done through an open approach.
The most common reason for noses to collapse after rhinoplasty is insufficient support
The key to both primary and revision rhinoplasty is support. The bony and cartilage structure that supports the nose needs to be maintained. Depending on how strong your cartilage is, more or less can be removed in rhinoplasty and not compromise breathing. Other ways to make a nasal tip smaller without removing a lot of cartilage is by the use of grafts of your own cartilage. I find that I use grafts of the patient's own cartilage in over 905 of primary rhinoplasties and almost 100% of revision nosejobs.